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The document is a registration form from the Maharashtra State OTPT Council for an individual named Harshada Bawanthade, applying for higher education in physiotherapy. It includes personal details, contact information, educational background, and internship details, along with instructions for submitting the application. The application number is 20250003395, and the registration fee is 3000.00.

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bawanthadeharshada4
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52 views3 pages

Print Reg Application

The document is a registration form from the Maharashtra State OTPT Council for an individual named Harshada Bawanthade, applying for higher education in physiotherapy. It includes personal details, contact information, educational background, and internship details, along with instructions for submitting the application. The application number is 20250003395, and the registration fee is 3000.00.

Uploaded by

bawanthadeharshada4
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

MAHARASHTRA STATE OTPT COUNCIL

DMER, 4th Floor, [Link]'s Hospital Campus, Mumbai -


400001 Fax No. : 022-22620408 Tel. No. : 022-22620408
e-Mail : otptcouncil@[Link] Website :
[Link]
REGISTRATION
Print Date : 04/12/2025

Note :- 1. Photo should be click on apron.


2. Photo should be attested by Principal of U.G. College.
3. Send Printed Application Form along with D.D.(Demand Draft and Xerox Copy) and
Three copies of latest photographs click on apron(1. photo of Size 4.5 x 3.5 cm ,
[Link] of Size 3.5 x 3.5 cm,[Link] of Size 2.5 x 2.5 cm).
4. Submit One set of self attested photo copies of all Scan document.

Application Details

Application Number : Application Date : State : Maharashtra


20250003395 28/11/2025

Basics Details

Prefix : Ms.
First Name : Harshada Middle Name : Last Name : Bawanthade
Gajendranath Date Of Birth : 26/06/1999
Sex : Female Marital Status : Single Nationality : India
Birth Place : gondia Purpose Of Registration : Last Name (Devnagari) :
Higher Education बावनथडे
First Name (Devnagari) : Middle Name (Devnagari) :
हर्षदा गजेंद्रनाथ

Father Name : Mr. Gajendranath Gendlal Mother Name : Mrs. Alka Gajendranath
Bawanthade Bawanthade
Maiden Name :
Contact Details

Clinic Tel. 7499414621 Residential Tel. 7499414621


Mobile No. 7499414621 E-Mail
bawanthadeharshada1234@[Link]
Residential Address
Address : * janta colony State :* Maharashtra District :* Gondia
gondia City : gondia Village/Town : gondia
Pin Code : 441601
Profesional Address

Is Residential address same as address for Professional Address.


Address : janta colony State : Maharashtra District : Gondia
gondia District : Gondia City : gondia
Pin Code : 441601
Educations Details

Basic Qualification : Course :


Bachelor in Physiotherapy PHYSIO THERAPY
Course Duration : Institute : Institute Place :
5 Years SHRI. K R PANDAV NATIONAL HIGHWAY 6,
COLLEGE OF BHILEWADA,
PHYSIOTHERAPY, MAHARASHTRA 441924
BHILEWADA, BHANDARA University :
Maharshatra University
Of Health Science,Nashik
University Place: Passing Date :
Mhasrul,Wani-Dindori 04/04/2025
Road.
Internship Details

[Link]. Appl No Start Date End Date

1 20250003395 04/04/2025 10/10/2025

Amount

Amount : 3000.00

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